What is a filling?
A filling is a conservative way to restore any small part of damaged tooth structure. The damage may be from fracture or decay. There are several different materials that can be used to fill a tooth. Things like where and why a tooth needs a filling may dictate which filling material can be used. Below is some information about each of the materials and the circumstances under which are best used.
Composite (tooth-colored) fillings:
Composite fillings are useful in repairing teeth with small to medium sized cavities or small fractures. Typically these fillings are done with the assistance of a dental dam. The dental dam keeps the teeth dry and isolated so that the resin adhesive can have the strongest bond possible. The benefits of composite fillings include very conservative removal of tooth structure and there are multiple shades available to make it look like you haven't had any dental work at all! Some of our composite work available to view here.
Amalgam (silver) fillings:
Amalgam fillings are also useful in repairing posterior (back) teeth with small to medium sized cavities. While most patients typically choose composite fillings, there are some instances where they cannot be placed. For instance, deeper gumline fillings that cannot be kept completely dry cannot be filled with composite because the resin bond would be very weak causing the filling to fail very quickly. In cases like this, amalgam or glass ionomer (see below) fillings are our only option. Amalgam fillings can be very long lasting when used in the proper conditions.
Glass Ionomer (white-colored) fillings:
Glass Ionomer is a very special material that is useful in some situations where composite is just not feasible. Glass Ionomer has very special properties that allow it to bond to the tooth surface in moist conditions, such as along the gumline. Being a weaker material, it is typically not used for permanent fillings on the chewing surfaces of teeth. A benefit of Glass Ionomer is that it acts like a fluoride sponge absorbing fluoride from your toothpaste. It will then slowly release it into the tooth for extended periods of time and decrease the chance of new decay forming around the filling. This is great for patients who have a high risk of cavities or very dry mouth, since fluoride has been scientifically proven to reduce the risk of new decay.1
Sedative (temporary) fillings:
Sedative fillings are used as a tool to "buy time." In the case where a cavity goes very deep and close to the root canal system, we will place an inexpensive sedative filling for a couple months. During this time, we wait and see if the tooth will heal itself or if it will start to ache and need a root canal
. The sedative filling has some medicinal properties to aid the tooth in healing and will reduce sensitivity. Another instance where sedative fillings are useful, is when a patient is needing multiple fillings, but is not financially able to have them all done right away. Sedative fillings cost about 50% (or less) the cost of permanent fillings, so more teeth can be fixed with less dental dollars. The problem with cavities is that they never get smaller with time, only bigger, and it is critical to stop the decay before it gets into the root canal system. Once a sedative filling is placed, a permanent filling (or crown
, depending on the extent of the decay) should be placed within one year due to the fact that temporary fillings are soft and are not meant to be in the mouth long-term.
Build-up fillings are used for medium to large cavities on teeth that are compromised enough to warrant a crown
. The filling material is used to replace the tooth structure that was lost due to decay. It acts as insulator to reduce sensitivity and gives the crown some solid structure to hold on to. Build-ups can be placed alone to stop progressing decay, but they are are softer restorative material and should be protected by the crown within one year.
1 Glass Ionomer: A Therapeutic Alternative to Direct Composite Restorations. By: Daniel H. Ward, DDS. oralhealthjournal.com April 1, 2010